@skeeza, having this (or just about any) discussion with you is like a video game. Arguments that have been vanquished keep popping up, and direct hits are ignored.

Here’s your argument:

I don’t want to pay for health insurance

If the law requires that I be provided life-saving measures even if I am not insured and cannot afford the treatment, then the law should be changed

As I have said, because you were broke and didn’t want to buy life insurance, you chose to potentially free load off the rest of us during that 10-year period. But we both got lucky. You were younger then, so the odds were longer.

Skeeza:

Funny, they didn’t seem to be dying in the streets before the ACA. They were being treated, they were uninsure, and my premiums were LOWER !!! How does that work?

I can never be sure whether you are trolling (because you occasionally make great points in other discussions), so it sometimes feels foolish to answer. However, many of your foolish arguments are common tropes so here are some responses:

By law, before the ACA, most hospitals were required to treat people dying in the streets regardless of whether they could pay.

Employer-based insurance premiums have continued to rise at rates that reflect pre-ACA increases and at rates that were projected. You are paying higher rates because health care costs have continued to rise (mostly) and because (to some degree) the ACA mandated some previously uncovered stuff that your employer’s product may not have covered, and insurers have struggled to price appropriately for the expanded market (bait-and-switch pricing to lure in new customers, a higher proportion of sick customers perhaps because healthy young people were choosing the low-cost penalty over higher-cost insurance, and Congress not coming through on promised funding to help companies recover from rate mistakes).

by Muhammad Aurangzeb Ahmad For those of us who work in the Sciences, the last decade or so has been a boon to research and new discoveries. This has been facilitated by the massive data collection and data analysis which...

For Holocaust Remembrance Day last week I read Hannah Arendt’s Eichmann In Jerusalem (h/t Ben Hoffman).

Adolf Eichmann organized the logistics of the Holocaust – helped get Jews into trains, helped get the trains to the right concentration camps. When Germany lost the war, he escaped to Argentina and lived under a fake name. The newly-formed state of Israel hunted him down, and in 1960 they kidnapped him and put him on trial in Jerusalem.

The Nuremberg Trials were led by an Allied force that wanted to stress that the Nazis committed crimes against all humanity. Eichmann’s trial was the first time Jews themselves tried a high-ranking Nazi for his crimes against Jews in particular. Israeli PM David Ben-Gurion wanted (and got) a show trial. Not in the sense of justice not being done (everyone agreed Eichmann was guilty), but in the sense of highlighting the horrors of the Holocaust to the world.

Arendt recorded a lot of weird, surprising, and disturbing things in her study of Eichmann’s trial. I found five particularly interesting: Eichmann’s psychological profile, the Nazis’ early pre-war plans for the Jews, the ways German-occupied nations did or didn’t resist genocide demands, the politics surrounding claims that Jews didn’t resist the Nazis enough, and the discussion of why more Germans didn’t protest.

You’re not answering at least one question here: what are we supposed to do with/for you IF you get some catastrophic medical condition, you have no health insurance, and you can’t afford it? What if it’s today and it’s $500,000? $400,000? $300,000? Whatever the cost is, in this scenario, you can’t afford to pay it. Then what?

Some people have problems with forum conversations. They only react to the last one or two posts. They don’t see the conversation being had.

tjb:

2004 study: males spend $270,000 on health care lifetime (less than women because we live longer), two-thirds in the last part of life.

Skeeza:

You make [million-dollar hospital bills] sound inevitable.

Depending on whether you think I don’t understand “average” or you don’t understand “average”, this is either a misunderstanding on your part or yet another misstatement or misdirection on your part.

Skeeza:

How many other people do you know that have run up a million dollar hospital tab ?

I don’t know any – so long as we discount my unfair advantage of meeting the people I met during my stay in intensive care, the ventilation unit and then at New England Rehab. Unlike what I have seen implied by others in this thread, I do believe you can make a rational case for playing the odds and paying as you go. Not the issue.

jyd:

what are we supposed to do with/for you IF you get some catastrophic medical condition, you have no health insurance, and you can’t afford it? What if it’s today and it’s $500,000? $400,000? $300,000? Whatever the cost is, in this scenario, you can’t afford to pay it. Then what?

Despite @skeeza’s ADHD approach to this pretty simple problem, it does boil down to that.

The rest of us are required to pay for freeloaders who have life-threatening conditions

Hospitals are not allowed to refuse treatment to freeloaders

People who refuse to buy health insurance on “principle” and face life-threatening conditions they can’t afford are freeloaders

You’re not answering at least one question here: what are we supposed to do with/for you IF you get some catastrophic medical condition, you have no health insurance, and you can’t afford it? What if it’s today and it’s $500,000? $400,000? $300,000? Whatever the cost is, in this scenario, you can’t afford to pay it. Then what?

I have no idea why he’s conveniently avoiding this question. I’ve asked him the same thing at least 3 different times. His argument has zero merit until he provides a legit response to this one question.

How many other people do you know that have run up a million dollar hospital tab ?

Many. And thank goodness they all had health insurance. Several still needed help because they couldn’t pay their bills while off work for an extended period.

Skeeza:

I know it doesn’t take much to run up a $20K health tab, but that says a lot more about the extreme prices the healthcare industry is able to charge, than it does for the severity of an ailment.

I agree with you here to a point. But at least part of the reason is to cover uninsured people. If we all had coverage and the price of care was negotiated by insurance companies, that price would come down. That’s the reason I paid $39 for a bill that was something like $500 before my insurance company stepped in to say how much was allowed to be charged to me (for my deductible).

I have no idea why he’s conveniently avoiding this question. I’ve asked him the same thing at least 3 different times. His argument has zero merit until he provides a legit response to this one question.

Because this is a double sided question.

What if that NEVER happens, but hundreds of thousand are paid for my premiums?

Like I said, it’s a lottery situation.

You make a big deal because there is a slim chance that I may have a catastrophic accident. Yet, you conveniently ignore the actual situation where my premiums are going towards paying the health care for people are smokers, heavy drinkers, drug users, sedentary, overeaters, and generally unhealthy due to their own decisions.

Why don’t we have health insurance based on our actual physical condition?

I agree with you here to a point. But at least part of the reason is to cover uninsured people. If we all had coverage and the price of care was negotiated by insurance companies, that price would come down. That’s the reason I paid $39 for a bill that was something like $500 before my insurance company stepped in to say how much was allowed to be charged to me (for my deductible).

Is that how you really think it works?

You must be one of those people who shop at Kohls, will see a T-Shirt marked down from $50 to $30, and actually think you are getting a good sale price !!!

Why don’t we have health insurance based on our actual physical condition?

If you mean base our premiums off our current health? Interesting concept. But those who are unhealthy couldn’t afford it then. We do pay higher premiums for smoking. But that’s the only discriminating allowed. I’d be cool with adding a surcharge for being overweight too. But that’s probably too sensitive so wouldn’t fly.

You’re not answering at least one question here: what are we supposed to do with/for you IF you get some catastrophic medical condition, you have no health insurance, and you can’t afford it? What if it’s today and it’s $500,000? $400,000? $300,000? Whatever the cost is, in this scenario, you can’t afford to pay it. Then what?

Skeeza: Why don’t we have health insurance based on our actual physical condition?

If you mean base our premiums off our current health? Interesting concept. But those who are unhealthy couldn’t afford it then. We do pay higher premiums for smoking. But that’s the only discriminating allowed. I’d be cool with adding a surcharge for being overweight too. But that’s probably too sensitive so wouldn’t fly.

I’ve often thought that health insurance should be like life insurance. If you buy in early when you’re young and healthy (low risk) then it’s cheaper and over time you’ve build up a series of payments that will cover your costs later in life. If you try to buy life insurance in your 40’s, they screen you for all kinds of things to determine how long you’re going to live (i.e. how long you’ll pay in)… Health insurance would then work in a similar way if you wait that long to pay in.

At the end of the day, it’s called insurance (which should cover your risk of catastrophic loss, right?) but it has morphed into much more than that.

I’ve often thought that health insurance should be like life insurance. If you buy in early when you’re young and healthy (low risk) then it’s cheaper and over time

That’s a good idea, but the way the free market has developed, employers are the primary provider of health insurance, and the plans don’t follow you when you switch jobs (save for some COBRA protections), and employers (in my experience) frequently switch carriers.

MarkH:

which should cover your risk of catastrophic loss, right?

Catastrophic can be in the eye of the beholder. We insure a lot of things (renter’s insurance, car insurance) that cost less than a medium-length hospital stay. Whether that’s sensible is another matter (see @skeeza’s many dodges of the real questions his arguments raise).